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Surgical Care during Humanitarian Crises: A Systematic Review of Published Surgical Caseload Data from Foreign Medical Teams

Published online by Cambridge University Press:  17 May 2012

Jason W. Nickerson ,
Smita Chackungal ,
Lisa Knowlton ,
Kelly McQueen  and
Frederick M. Burkle Jr.
Jason W. Nickerson*
Affiliation:
Centre for Global Health, University of Ottawa, Ottawa, Ontario Canada
Smita Chackungal
Affiliation:
Division of General Surgery, University of Western Ontario, London, Ontario Canada Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Lisa Knowlton
Affiliation:
Division of General Surgery, University of British Columbia, Vancouver, British Columbia Canada Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Kelly McQueen
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Frederick M. Burkle Jr.
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA Senior Public Policy Scholar, Woodrow Wilson International Center for Scholars, Washington, D.C.
*
Correspondence: Jason Nickerson, RRT, PhD (Candidate) Centre for Global Health University of Ottawa 1 Stewart St. Ottawa K1N 6N5 Ontario Canada E-mail [email protected]
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Abstract

Objective

Humanitarian surgery is often organized and delivered with short notice and limited time for developing unique strategies for providing care. While some surgical pathologies can be anticipated by the nature of the crisis, the role of foreign medical teams in treating the existing and unmet burden of surgical disease during crises is unclear. The purpose of this study was to examine published data from crises during the years 1990 through 2011 to understand the role of foreign medical teams in providing surgical care in these settings.

Methods

A literature search was completed using PubMed, MEDLINE, and EMBASE databases to locate relevant manuscripts published in peer-reviewed journals. A qualitative review of the surgical activities reported in the studies was performed.

Results

Of 185 papers where humanitarian surgical care was provided by a foreign medical team, only 11 articles met inclusion criteria. The reporting of surgical activities varied significantly, and pooled statistical analysis was not possible. The quality of reporting was notably poor, and produced neither reliable estimates of the pattern of surgical consultations nor data on the epidemiology of the burden of surgical diseases. The qualitative trend analysis revealed that the most frequent procedures were related to soft tissue or orthopedic surgery. Procedures such as caesarean sections, hernia repairs, and appendectomies also were common. As length of deployment increased, the surgical caseload became more reflective of the existing, unmet burden of surgical disease.

Conclusions

This review suggests that where foreign medical teams are indicated and requested, multidisciplinary surgical teams capable of providing a range of emergency and essential surgical, and rehabilitation services are required. Standardization of data collection and reporting tools for surgical care are needed to improve the reporting of surgical epidemiology in crisis-affected populations.

Nickerson JW, Chackungal S, Knowlton L, McQueen K, Burkle FM Jr. Surgical care during humanitarian crises: a systematic review of published surgical caseload data from foreign medical teams. Prehosp Disaster Med. 2012;27(2):1-6.

Keywords

disasterdisaster reliefforeign medical teamhumanitarian reliefsurgical emergency
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 2 , April 2012 , pp. 184 - 189
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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References

1. Farmer, PE, Kim, JY. Surgery and global health: a view from beyond the OR. World J Surg. 2008;32(4):533-616.CrossRefGoogle ScholarPubMed
2. Ozgediz, D, Riviello, R. The “other” neglected diseases in global public health: surgical conditions in Sub-Saharan Africa. PLoS Med. 2008;5(6):e121.CrossRefGoogle Scholar
3. Ozgediz, D, Riviello, R, Rogers, SO. The surgical workforce crisis in Africa: a call to action. Bull Am Coll Surg. 2008;93(8):10-16.Google Scholar
4. Ivers, LC, Garfein, ES, Augustin, J, et al. . Increasing access to surgical services for the poor in rural Haiti: surgery as a public good for public health. World J Surg. 2008;32(4):537-542.CrossRefGoogle ScholarPubMed
5. World Health Organization (WHO) Inter-Agency Standing Committee GHC Policy and Strategy Team. Coordination and registration of providers of foreign medical teams in the humanitarian response to sudden-onset disasters: a Health Cluster concept paper. http://www.who.int/hac/global_health_cluster/about/policy_strategy/fmt_concept_paper_27_May.pdf. 2010. Accessed August 29, 2011.Google Scholar
6. Mills, EJ. Sharing evidence on humanitarian relief. BMJ. 2005;331(7531):1485-1486.CrossRefGoogle ScholarPubMed
7. Spiegel, P. Who should be undertaking population-based surveys in humanitarian emergencies? Emerg Themes Epidemiol. 2007;4(1):12.CrossRefGoogle ScholarPubMed
8. Spiegel, PB, Robinson, C. Large-scale “expert” mortality surveys in conflicts — concerns and recommendations. JAMA. 2010;304(5):567-568.CrossRefGoogle ScholarPubMed
9. Grais, R, Luquero, F, Grellety, E, Pham, H, Coghlan, B, Salignon, P. Learning lessons from field surveys in humanitarian contexts: a case study of field surveys conducted in North Kivu, DRC 2006-2008. Confl Health. 2009;3(1):8.CrossRefGoogle ScholarPubMed
10. Pavignani, E, Colombo, S. Analysing disrupted health sectors: a modular manual. Geneva, Switzerland: World Health Organization; 2009.Google Scholar
11. Chu, K, Trelles, M, Ford, N. Rethinking surgical care in conflict. Lancet. 2010;375(9711):262-263.CrossRefGoogle ScholarPubMed
12. McGowan, J, Sampson, M, Lefebvre, C. An evidence based checklist for the peer review of electronic search strategies (PRESS EBC). Evid Based Libr Inf Prac. 2010;5(1):149-154.CrossRefGoogle Scholar
13. Bar-Dayan, Y, Beard, P, Mankuta, D, et al. . An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces Field Hospital in Adapazari. Disasters. 2000;24(3):262-270.CrossRefGoogle ScholarPubMed
14. Korver, AJH. Amputees in a hospital of the International Committee of the Red Cross. Injury. 1993;24(9):607-609.CrossRefGoogle Scholar
15. Rosenfeld, JV. Neurosurgery in Rwanda during a United Nations peace-keeping mission. Mil Med. 1997;162(5):311-314.CrossRefGoogle ScholarPubMed
16. Bozkurt, M, Ocguder, A, Turktas, U, Erdem, M. The evaluation of trauma patients in Turkish Red Crescent Field Hospital following the Pakistan earthquake in 2005. Injury. 2007;38(3):290-297.CrossRefGoogle ScholarPubMed
17. Rowley, DI. The management of war wounds involving bone. J Bone Joint Surg Br. 1996;78(5):706-709.CrossRefGoogle ScholarPubMed
18. Roy, N, Shah, H, Patel, V, Coughlin, RR. The Gujarat earthquake (2001) experience in a seismically unprepared area: community hospital medical response. Prehosp Disaster Med. 2002;17(4):186-195.CrossRefGoogle Scholar
19. Wolf, Y, Bar-Dayan, Y, Mankuta, D, et al. . An earthquake disaster in Turkey: assessment of the need for plastic surgery services in a crisis intervention field hospital. Plast Reconstr Surg. 2001;107(1):169-170.CrossRefGoogle Scholar
20. Bar-Dayan, Y, Leiba, A, Beard, P, et al. . A multidisciplinary field hospital as a substitute for medical hospital care in the aftermath of an earthquake: the experience of the Israeli Defense Forces Field Hospital in Duzce, Turkey, 1999. Prehosp Disaster Med. 2005;20(2):103-106.Google ScholarPubMed
21. Bridgewater, FH, Aspinall, ET, Booth, JP, et al. . Team Echo: observations and lessons learned in the recovery phase of the 2004 Asian tsunami. Prehosp Disaster Med. 2006;21(1):s20-25.CrossRefGoogle ScholarPubMed
22. Chambers, AJ, Campion, MJ, Courtenay, BG, Crozier, JA, New, CH. Operation Sumatra Assist: surgery for survivors of the tsunami disaster in Indonesia. ANZ J Surg. 2006;76(1):39-42.CrossRefGoogle ScholarPubMed
23. Helminen, M, Saarela, E, Salmela, J. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the first three weeks of operation. Emerg Med J. 2006;23(8):654-656.CrossRefGoogle ScholarPubMed
24. Paix, BR, Capps, R, Neumeister, G, Semple, T. Anaesthesia in a disaster zone: a report on the experience of an Australian medical team in Banda Aceh following the ‘Boxing Day tsunami’. Anaesth Intensive Care. 2005;33(5):629-634.CrossRefGoogle Scholar
25. Schnitzer, JJ, Briggs, SM. Earthquake relief — the U.S. medical response in Bam, Iran. NEJM. 2004;350(12):1174-1176.CrossRefGoogle ScholarPubMed
26. Riddez, L, Kruck, M, Gardarsdottir, H, Redwood-Campbell, L. The surgical and obstetrical activity at the ICRC field hospital in Banda Aceh in the aftermath of the tsunami 2004. International Journal of Disaster Medicine. 2005;3(1-4):55-60.CrossRefGoogle Scholar
27. Chu, K, Havet, P, Ford, N, Trelles, M. Surgical care for the direct and indirect victims of violence in the eastern Democratic Republic of Congo. Confl Health. 2010;4:6.CrossRefGoogle ScholarPubMed
28. Farrow, GB, Rosenfeld, JV, Crozier, JA, Wheatley, P, Warfe, P. Military surgery in Rwanda. ANZ J Surg. 1997;67(10):696-702.Google ScholarPubMed
29. Morris, DS. Surgeons and the International Committee of the Red Cross. ANZ J Surg. 1992;62(3):170-172.Google ScholarPubMed
30. Sundin, JA. War surgery in Kigali, Rwanda: The role of the International Committee of the Red Cross. Tech Orthop. 1995;10(3):250-258.CrossRefGoogle Scholar
31. Noor, A, Alegana, V, Gething, P, Snow, R. A spatial national health facility database for public health sector planning in Kenya in 2008. Int J Health Geogr. 2009;8(1):13.CrossRefGoogle ScholarPubMed
32. Holian, AC, Keith, PP. Orthopaedic surgery after the Aitape tsunami. Med J Aust. 1998;169(11-12):606-609.CrossRefGoogle ScholarPubMed
33. Sjoberg, L, Yearwood, R. Impact of a category-3 hurricane on the need for surgical hospital care. Prehosp Disaster Med. 2007;22(3):194-198.CrossRefGoogle ScholarPubMed
34. Mohebbi, HA, Mehrvarz, S, Saghafinia, M, et al. . Earthquake related injuries: assessment of 854 victims of the 2003 Bam disaster transported to tertiary referral hospitals. Prehosp Disaster Med. 2008;23(6):510-515.CrossRefGoogle ScholarPubMed
35. Krieg, CM, Gardemann, J. A record of morbidity and medical request profiles in international humanitarian aid, taking the earthquake in Bam in Iran in 2003 as an example. J Public Health. 2009;17(2):97-106.CrossRefGoogle Scholar
36. Abolghasemi, H, Radfar, MH, Khatami, M, Nia, MS, Amid, A, Briggs, SM. International medical response to a natural disaster: lessons learned from the Bam earthquake experience. Prehosp Disaster Med. 2006;21(3):141-147.CrossRefGoogle ScholarPubMed
37. Bradt, DA, Aitken, P. Disaster medicine reporting: the need for new guidelines and the CONFIDE statement. Emerg Med Australas. 2010;22(6):483-487.CrossRefGoogle ScholarPubMed